Glossary
The words that get used around FTM surgery as if everyone already knows them. Each entry gives the plain meaning first, then the context: where you'll meet the term, why it matters for you, and which pages on the site go deeper.
I add terms as they come up in the procedure pages, so this list grows. If a word you've hit isn't here, tell me and I'll write it.
Terms A–Z
A
ALT (anterolateral thigh flap)
Anterolateral thigh flap: a phalloplasty built from skin and fat taken from the front-outer thigh. The main alternative to the forearm flap for people who want a donor scar they can cover.
D
Dilation
Stretching a narrowed urethra with graded rods or a catheter to treat a stricture after urethral lengthening. Not the vaginal dilation of MTF surgery; nothing in FTM surgery needs routine dilation.
Double incision
The most common top surgery technique. Two horizontal cuts along the line of the pec fold remove the breast tissue and spare skin; the nipples are resized and reattached as free grafts.
Dysphoria
The distress of a mismatch between body and gender, and the diagnostic label letters and funders require. Not constant or severe by definition, and not a word every trans person uses.
E
Erectile implant
A device placed inside a phalloplasty penis so it can get hard enough for penetrative sex. Also called a penile prosthesis or "the pump". Fitted as a separate, later operation, and optional.
F
Fistula
A hole in the newly built urethra that lets urine leak out along the shaft. The most common complication of urethral lengthening; small ones often close on their own, others are repaired later.
G
Glansplasty
Sculpting a head (glans) on the tip of a phalloplasty phallus: a ridge is cut around the shaft and a groove grafted below it so the flap reads as a circumcised penis. Also called coronaplasty.
H
Hematoma
A pocket of blood under the skin in the first day or two after surgery, the classic early top surgery complication. Small ones settle; large ones go back to theatre to protect skin and grafts.
Hysterectomy
Surgical removal of the uterus. Done on its own, alongside top surgery, or as the first step before metoidioplasty or phalloplasty; often combined with removal of the ovaries and tubes.
I
Informed consent
A care model where the surgeon assesses your readiness instead of a therapist, so no referral letter. Common for hormones, some private top surgery (mostly US), rare for bottom surgery.
K
Keyhole
The smallest top surgery technique. Breast tissue is removed through a short cut along the lower edge of the areola, mostly by liposuction, with no skin taken. Only works on a small chest with tight skin.
L
Letter of support
A letter from a qualified clinician confirming you meet the criteria for a named surgery. One for top surgery, usually two for genital surgery; days to obtain privately, years via public clinics.
M
Metoidioplasty
Meta. The genital surgery that builds a small phallus from the clitoris testosterone has already enlarged, by releasing it from the ligament holding it down. Nothing is taken from elsewhere on the body.
N
Nipple graft
The nipple removed, trimmed smaller and stitched back on as a patch of skin with no nerve supply. Standard in double incision; sensation usually lost, full graft failure uncommon.
O
Oophorectomy
Surgical removal of one or both ovaries, usually at the same time as a hysterectomy. Ends natural oestrogen production and fertility, which is why some people keep one ovary.
P
Peri-areolar
A top surgery technique that removes breast tissue through a cut around the edge of the areola, with the nipple kept on its own blood supply. Suits small, tight chests; has the highest revision rate.
Phalloplasty
Phallo. The genital surgery that builds a full-sized penis from a flap of your own skin and fat taken from elsewhere, most often the forearm or thigh, in several stages over one to two years.
R
RFF (radial forearm flap)
Radial forearm free flap, the most common phalloplasty technique. Skin, fat, nerves and vessels from the inner forearm are rolled into a phallus, moved to the groin and reconnected under a microscope.
S
Scrotoplasty
The operation that builds a scrotum, nearly always from the labia majora, as part of metoidioplasty or phalloplasty. It leaves an empty pouch; testicular implants are a separate step months later.
SOC8
Version 8 of the WPATH Standards of Care, published in 2022. The current edition of the guidance most surgeons and funders use for eligibility: one letter, six months on hormones before genital surgery.
Stricture
A scar-tissue narrowing of the new urethra that slows or blocks the stream, usually showing up months after urethral lengthening. Treated with dilation or a later revision; often paired with fistula.
T
Top surgery
Chest masculinisation: removing the breast tissue and reshaping the chest, with the nipples repositioned or grafted, to give a flat male contour. The procedure most trans men have first, and for many the only one.
U
Urethral lengthening
Extending the urethra to the tip of the new phallus so you can stand to pee. Optional in both meta and phalloplasty, and the part most likely to leak or narrow.
V
Vaginectomy
Surgical removal or closure of the vaginal canal. Usually done as part of metoidioplasty or phalloplasty, and required by most surgeons when the urethra is being lengthened.
W
WPATH
The World Professional Association for Transgender Health, whose Standards of Care (SOC8, 2022) set the eligibility criteria most surgeons and insurers use. Guidance, not law.
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